Maternal medically diagnosed infection and antibiotic prescription during pregnancy and risk of childhood cancer: A population-based cohort study in Taiwan, 2004 to 2015.

in International journal of cancer by Anupong Sirirungreung, Pei-Chen Lee, Ya-Hui Hu, Zeyan Liew, Beate Ritz, Julia E Heck

TLDR

  • This study looked at whether there is a link between maternal infections during pregnancy and the risk of childhood cancer in offspring. They used a large database of mother-child pairs in Taiwan and found that maternal infections during pregnancy were associated with a higher risk of childhood hepatoblastoma and a lower risk of childhood acute lymphoblastic leukemia. They also found that antibiotic prescriptions during pregnancy were associated with a higher risk of childhood ALL, particularly with tetracyclines. These findings suggest that there may be a link between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL.

Abstract

While associations between maternal infections during pregnancy and childhood leukemia in offspring have been extensively studied, the evidence for other types of childhood cancers is limited. Additionally, antibiotic exposure during pregnancy could potentially increase the risk of childhood cancers. Our study investigates associations between maternal infections and antibiotic prescriptions during pregnancy and the risk of childhood cancer in Taiwan. We conducted a population-based cohort study using the Taiwan Maternal and Child Health Database (TMCHD), linked with national health and cancer registries. The study included 2 267 186 mother-child pairs, and the median follow-up time was 7.96 years. Cox proportional hazard models were utilized to estimate effects. Maternal infections during pregnancy were associated with a moderate increase in the risk of childhood hepatoblastoma (adjusted hazard ratio [HR] = 1.34; 95% confidence interval [CI]: 0.90-1.98) and a weaker increase in the risk of childhood acute lymphoblastic leukemia (ALL) (adjusted HR = 1.15; 95% CI: 0.99-1.35). Antibiotic prescriptions during pregnancy were also associated with an elevated risk of childhood ALL (adjusted HR = 1.30; 95% CI: 1.04-1.63), particularly with tetracyclines (adjusted HR = 2.15; 95% CI: 1.34-3.45). Several specific antibiotics were also associated with an increased risk of hepatoblastoma and medulloblastoma. Children exposed in utero to antibiotic prescription or both infections and antibiotics during pregnancy were at higher risk of developing ALL. Our findings suggest that there are associations between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL and highlight the importance of further research in this area.

Overview

  • The study investigates associations between maternal infections and antibiotic prescriptions during pregnancy and the risk of childhood cancer in Taiwan using a population-based cohort study with the Taiwan Maternal and Child Health Database (TMCHD) linked with national health and cancer registries. The study included 2,267,186 mother-child pairs and the median follow-up time was 7.96 years. Cox proportional hazard models were utilized to estimate effects. The primary objective of the study is to investigate the associations between maternal infections and antibiotic prescriptions during pregnancy and the risk of childhood cancer in Taiwan.

Comparative Analysis & Findings

  • The study found that maternal infections during pregnancy were associated with a moderate increase in the risk of childhood hepatoblastoma (adjusted hazard ratio [HR] = 1.34; 95% confidence interval [CI]: 0.90-1.98) and a weaker increase in the risk of childhood acute lymphoblastic leukemia (ALL) (adjusted HR = 1.15; 95% CI: 0.99-1.35). Antibiotic prescriptions during pregnancy were also associated with an elevated risk of childhood ALL (adjusted HR = 1.30; 95% CI: 1.04-1.63), particularly with tetracyclines (adjusted HR = 2.15; 95% CI: 1.34-3.45). Several specific antibiotics were also associated with an increased risk of hepatoblastoma and medulloblastoma. Children exposed in utero to antibiotic prescription or both infections and antibiotics during pregnancy were at higher risk of developing ALL. These findings suggest that there are associations between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL.

Implications and Future Directions

  • The study's findings highlight the importance of further research in this area and suggest that there are associations between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL. The study's limitations include the potential for recall bias and the possibility of unmeasured confounding factors. Future research should address these limitations and explore the potential mechanisms underlying these associations. Possible future research directions include investigating the effects of specific antibiotics on the risk of childhood cancers and examining the potential role of the microbiome in these associations.
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